Hi everyone,

Heparin Drip Protocols can widely vary in how they establish maximum thresholds for initial doses and subsequent boluses/continuous rates.

For instance, one standard approach to acute coronary syndromes incorporates:
1. Initial Bolus = 60 units/kg (maximum: 4,000 units)
2. Followed by 12 units/kg/hour (maximum: 1,000 units/hour) continuous rate

Our system has begun to explore removal of these maximum dose caps to avoid mix-ups and calculation/transcription errors surrounding conversion between “unit” and “mL”. This becomes particularly challenging to assess and implement within obese and morbidly obese patients.

We would be incredibly grateful to hear what others are doing for their own heparin protocols (i.e., ACS and VTE).

1. Do you include initial dose and bolus/continuous rate maximums? If yes, what are they?

2. What are your experiences in obese/morbidly obese patients?

Thank you,

Zach